The first step in treatment for cocaine addiction is getting the addict to agree to treatment. Many users think they have their problem under control, even in the face of evidence to the contrary. Many come by way of the courts and although they will admit they screwed up, they still think they are in control.
Treatment for cocaine addiction is almost always done on an inpatient basis. This can be in a hospital, a clinic, or a rehab facility. The physical symptoms are not considered life threatening, and they pass in less than a week for most patients, but the psychological cravings and mental effects do not. The purpose of an inpatient setting for cocaine addiction treatment is more to control a patient’s access to the drug as much as for medical treatment.
Drugs used in detox address specific symptoms. For depression, anti-depressants such as desipramine can be used. For anxiety, the benzodiazepines (Valium, Xanax) are used, sometimes also as sleep aids.
Drugs meant to offset neurological changes due to cocaine abuse include the Parkinson’s drug, Amantadine and Bromocriptine, which is a dopamine-like drug meant to simulate the effects of cocaine and reduce cravings. For stress induced high blood pressure and tachycardia, Propranolol is sometimes prescribed.
To date, there is no specific drug which will stop the severe cravings that emerge with cocaine withdrawal.
Rehabilitation in cocaine addiction consists of targeted therapy combined with general group therapy. The goals are to educate patients about the drug and help them adopt strategies to combat use. Rehab is most effective when continued on an inpatient basis for up to three months. Unfortunately, this is an expensive treatment option and not all addicts will be able to take advantage of it.
One of the triggers for cocaine cravings is the normally insignificant down-mood all of us feel from time to time. For an addict, ‘the blues’ can lead to a relapse. This makes recovery particularly hard – therapy must address other life issues and techniques to handle them, beyond drug use.
The twelve step group for cocaine addiction treatment is called Cocaine Anonymous (C.A.) (the link will take you to a directory by state). Another program available is Narcotics Anonymous (N.A.) where addicts of many drugs meet. Even some Alcoholics Anonymous groups will allow those addicted to other substances to attend meetings.
Along with 12-step meetings, many cocaine addicts agree to monitoring by family and friends. Supervision that limits access to money, transportation, and privacy can help reduce opportunities to relapse. By agreeing to be policed, the addict adds another barrier to surmount, making it harder to act on their craving. This usually means abandoning the old contacts – both friends and ‘drug buddies’ – that are still using.
One of the hardest parts of maintaining abstinence is finding a way of life that is valuable and rewarding after cocaine and the party lifestyle. Addicts have to actively seek this out during cocaine addiction treatment, rather than hoping that just not using will magically fix all their problems.